Newer Methods of Pain Relief in Dental Practice

Newer Methods of Pain Relief in Dental Practice

By Dr. Latha Nayak

The very thought of pain during a dental procedure makes most of the people postpone their visit to a dentist! Newer advancements that have been made in the field of local anesthesia are going to make this fact no more right. That means dentists are now able to provide adequate pain control without even giving you a prick sometimes! As always considered an effective use of local anesthesia is the cornerstone in modern era dental practice. Most commonly, the discomfort experienced during a local anesthetic injection is the main reason for fear among patients and is a significant concern for the dentists. Newer technologies have arrived to overcome this problem and ensure adequate pain control in patients undergoing dental treatment. The 7 techniques that reduce pain during injection are listed as follows:

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  • Electronic Dental Anesthesia (EDA): This makes use of the Transcutaneous Electrical Nerve Stimulation (TENS) principle to provide pain relief. However, it causes increased saliva production and hindrance to the usage of metal instruments. Patients with heart disease, pacemakers, cochlear implants, neurological problems, seizures, and brain tumors are not eligible for this type of anesthesia.
  • Intra-oral Lignocaine Patch (Dentipatch): This is a patch containing 10-20% of lidocaine. This needs to be placed for about 15 minutes over the dried mucosa before giving an injection. This is efficacious in providing good topical anesthesia, and can be used both in the upper and lower jaws.
  • Jet Injection: This involves the use of a small quantity of local anesthetic that is directed onto the submucosa in the form of a jet. No syringe or needle is required, but air pressure which causes a fine jet of solution gains entry into the mucosa through a minute wound and produces topical anesthesia. This method is efficient in injections to the palatal region.
  • Iontophoresis: This is a method that involves electrical transport of ionic particles into the hard and soft tissues in order to gain therapeutic benefits. By this technique, the anesthetic can be placed precisely in the region where it is required without causing systemic side effects.
  • Eutectic Mixture of Local Anesthetics (EMLA): This is a mixture containing lignocaine and prilocaine bases, which transforms into an oil phase in the cream, and has the property of percolating into the intact skin. EMLA cream is applied to the mucosa prior to inserting the needle.
  • Computer-Controlled Local Anesthetic Delivery Devices (CCLAD): This is a local anesthetic drug delivery system that makes use of computer technology to manipulate the flow of the anesthetic solution through the needle. The product is marketed as Comfort Control Syringe (Dentsply International, York, PA, USA). The unique feature of this device is the ability to continuously infiltrate smaller amounts of local anesthetic solution during insertion of the needle, which reduces the pain experienced during an injection. The anesthetic solution is infused in a controlled and steady manner which further reduces the discomfort to the patient. As a result, these devices are well tolerated by patients and can be employed during root canal therapies and even extraction of teeth in children.
  • Intra-osseous Systems (IO Systems): This system uses a motor driven perforator to penetrate the buccal gingiva and the bone. It is the first modern technique of IO anesthesia. These devices are capable of injecting the local anesthetic solution directly into the cancellous bone close to the apical portion of the tooth root. The devices commonly used are Stabident, X – Tip, and Intraflow. This system makes profound anesthesia possible during the treatment of irreversible pulpitis of lower molar teeth. It is also useful while treating children and adolescents by virtue of its quicker onset of action.

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Newer drugs and techniques need to be constantly updated and incorporated into our day-to-day practice so as to make the objectives of pain-free dentistry a reality. It is better to adopt these newer proven techniques whenever feasible as these can provide the patients with the best care ever!

References:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800379/

http://www.iosrjournals.org/iosr-jdms/papers/Vol1-issue4/B0141016.pdf